Clinton Announces New Program to Train 150,000 Indian Doctors; India's HIV Statistics Disputed

The Clinton Foundation will help India's National AIDS Control Organization train 150,000 doctors over the next year to treat HIV/AIDS patients in the country, former President Clinton said on Thursday in New Delhi, the AP/Atlanta Journal-Constitution reports (Mahapatra, AP/Atlanta Journal-Constitution, 5/27). The program will provide Indian physicians with training in local HIV/AIDS epidemiology and virology; modes of HIV transmission, including mother-to-child, and disease progression; patient evaluation methods; case management; national antiretroviral drug guidelines; post-exposure prophylaxis; and treatment guidelines, according to a Clinton Foundation release. The U.K. Department for International Development will provide some of the funding and technical expertise for the initiative, according to the release (Clinton Foundation release, 5/26). Clinton said the lack of health care facilities and trained physicians in India is hindering HIV-positive people's access to treatment. The Clinton Foundation in September 2004 agreed to help NACO set up the Indian government's national antiretroviral treatment program in about 188 clinics and hospitals around the country, according to the Hindu.

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"In India, where an estimated 80% of health care services are provided by private-sector hospitals and private physicians, it is imperative that they are given the tools needed to provide standardized, high-quality care and treatment to those who need it," Clinton said at a national HIV/AIDS conference organized by NACO, the Clinton Foundation and the India Business Trust for HIV/AIDS (Dhar, Hindu, 5/27). The foundation has pledged to help NACO train up to 700,000 doctors over the next few years, Xinhuanet reports. "We need these trained doctors so that we can quickly spread drugs to all the people," Clinton, who is on a two-day visit to India to speak about HIV prevention and relief efforts in response to the December 2004 Indian Ocean tsunami, said (Xinhuanet, 5/26). "No one agency, public or private, can reach enough people," Susanna Moorehead, head of DFID in India, said, adding, "Private doctors are an important part of this partnership" (Clinton Foundation release, 5/26).

U.S. Should Purchase More Generic Drugs, Clinton Says
Clinton on Thursday also said the United States should use more of its global HIV/AIDS funding to purchase generic antiretroviral drugs, adding that he has discussed the issue with President Bush, according to the AP/Journal-Constitution. "We need greater flexibility in the money that the U.S. has appropriated," Clinton said, adding, "American companies have been too harsh" in lobbying the U.S. government to restrict the purchase of generic drugs. Clinton also said that India's new patent law, which prevents Indian generic drug firms from copying newly patented medicines, might hurt efforts to improve access to antiretroviral drugs worldwide (AP/Atlanta Journal-Constitution, 5/27). The law is meant to bring the country in line with a World Trade Organization agreement on intellectual property that it signed in 1994. The Indian government says that recognizing patents is a necessary precondition for the nation's drug industry to pursue additional drug research and development and attract foreign investors (Kaiser Daily HIV/AIDS Report, 3/24). Clinton said he will "do the very best" he can to persuade U.S. drug companies to grant compulsory licenses to Indian companies allowing them to make generic equivalents, the AP/Journal-Constitution reports (AP/Atlanta Journal-Constitution, 5/27).

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Number of New HIV Cases Disputed
The Indian government on Thursday said that new NACO data showing a nearly 95% decrease in the number of newly reported HIV cases in 2004 could be "misleading," Reuters AlertNet reports (Zaheer, Reuters AlertNet, 5/26). According to data released by NACO on Wednesday, 28,000 new HIV cases were reported in India in 2004, compared with 520,000 new cases in 2003. The data -- collected by the Indian independent organizations Institute of Research in Medical Statistics and the National Institute of Health and Family Welfare -- used UNAIDS and World Health Organization recommendations, but some AIDS advocates in the country said they dispute the numbers because no nongovernmental organizations that work with HIV-positive people have registered a corresponding drop in new demand for services (Kaiser Daily HIV/AIDS Report, 5/26). "Our numbers may not be exactly accurate," Science Minister Kapil Sibal said at the conference in New Delhi, adding that poor health care and other diseases have meant many HIV-positive people might have died of other causes before being recorded as a new HIV case. Irfan Khan -- program director for the Naz Foundation, a not-for-profit HIV/AIDS advocacy group -- said NACO's data do not include information from private blood banks, laboratories and volunteer groups. However, NACO said the figures had been vetted by UNAIDS and WHO. "Initially, even we were skeptical, ... but eventually we too were satisfied that these figures are reliable," NACO Director S.Y. Quraishi said (Reuters AlertNet, 5/26).

New York Times Examines HIV/AIDS Treatment Efforts in India
The New York Timeson Thursday examined efforts to treat HIV/AIDS patients in India, "where stigma, poverty, an anemic public health system and the sheer scale of the pandemic combine in a daunting challenge." Although the country is a leader in exporting generic antiretroviral drugs, less than 2% of the estimated 500,000 HIV-positive Indians who need the drugs are receiving treatment at no cost, according to the Times (Sengupta, New York Times, 5/27).

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